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Writer's pictureDr Charles Glassman

Does Health Insurance Cover Therapy?

Updated: Jan 16




Mental health is just as critical as physical health when it comes to your overall well-being. However, accessing mental health services can be expensive even to those who have a health insurance policy.

Intending to promote mental health, federal lawmakers enacted a law in 2008 by the name Mental Health Parity Act. Before this act, the law didn't require insurance companies to provide cover for mental health programs. But since the parity law and the Affordable Care Act (ACA), most insurance plans currently cover mental health care. Unfortunately, non-ACA plans may not. This, though, is a considerable improvement compared to what we had before these enactments.


Given that mental health coverage is still not as comprehensive as other coverage, it is good to ensure you are well-versed with the scope of your health insurance coverage before purchasing it.


What is typically covered under most insurance benefits?


What is covered will vary from one plan to the other. The coverage of most plans is divided into two categories – Dental Plans and Extended Health Benefits. The latter covers a wide variety of services, but they're usually intended to cover services that aren't covered by universal health care.


Prescription medications, advanced nursing, overseas treatment, emergency room renovations, wheelchairs/walkers, artificial limbs, paramedical services, advanced nursing, out of country medical treatment, artificial limbs/prosthesis/medical equipment, eye care, and paramedical services, and optical care are some of the available services.


Paramedical services include psychologists/mental health therapists, physiotherapists, osteopaths, chiropractors, podiatrists, optometrists, and massage. Paramedical Facilities often rely on a single funding source.


Does insurance cover therapy services?

To some extent, it can! Health insurance plans are different; therefore, it depends on the plan you have. Additionally, whether your therapy will be covered depends on the therapist you pick. Some therapists only accept specific insurance, while some don't take insurance at all. That is why this can be so confusing to many people. Several variables can affect your situation, and that may feel quite overwhelming in and of itself. However, by asking the right questions and contacting the right people, it is easy to figure this out.


Finding insurance policies that cover therapy and mental health


As we have already mentioned, there are currently no health insurance plans that expressly cover therapy or mental health. Mental health coverage is included in the framework of a medical health insurance program when it is available.


If you're looking for new health benefits and just want to look at policies that cover mental health, conduct a thorough online search, compare plans, and find one that meets your specific needs.


You can contact as many insurance providers via phone as a way of confirming their scope of coverage. Alternatively, you can get in touch with your preferred therapists and ask them the insurance providers they partner with. By this, you will be in a better position to make an informed decision.


What if you had an existing health care plan? What can you do about it? If your existing healthcare plan does not include therapy and mental health services, you might want to extend your quest for a new plan to include high-deductible health plans (HDHPs) that do. You could come out ahead even though the out-of-pocket deductible is lower than your actual yearly out-of-pocket expenses. HDHPs are often paired with a health savings plan, which allows you to cover the deductible with pre-tax funds.


Important details to keep in mind when hunting for health insurance coverage


It's important to understand how much coverage you have. Every detail is available from your insurance firm. The following are some questions you should always ask when looking for an insurance cover that extends to mental health services:


  1. What kinds of clinicians am I covered for? They may include psychologists, Certified Counselors, social workers, etc.

  2. When does my insurance coverage 'renew' or 'roll-over'?

  3. Is there a maximum amount of coverage (annual or lifetime)? If that's the case, what is it?

  4. What happens if I use up all of my sessions/coverage but still need therapy?

  5. Can they cater for both in- and out-patient services?

  6. What details would be included in the reports if I am on disability?

  7. What happens if you have other pre-existing health conditions?

  8. Do I have to see the psychologist/therapist my case manager refers me to, or may I request to consult with someone of my choosing?


Final thoughts


If you know you might need insurance that covers mental health, then it is vital to pick a reliable provider that expressly offers this cover. There is no harm in taking time to shop around for an insurance provider that will cater to your needs.

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